Ketamine, Depression & the OODA Loop: How Ember Health Reorients the Patient Journey

Mar 26, 2026

Tiffany Franke, co-founder and design lead who shapes set-and-setting and care coordination. Dr. Nico Grundmann, emergency physician and medical co-founder overseeing evidence-based IV ketamine and thousands of infusions. They discuss safety and monitoring, designing therapeutic spaces and rituals, integrating measurement-based care with patient experience, treating postpartum and adolescent populations, and strategies to expand insurance access.

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ADVICE

Grow Specialized Care Through Trusted Referrals

Build referrals and trusted-provider networks rather than consumer advertising for specialized medical services.
Nico and Tiffany decided early to accept referrals from therapists, psychiatrists, and PCPs to preserve trust and integrate care.

INSIGHT

Tiny Rituals Shape Patient Safety Perception

Small experience details create large signals of safety and welcome in psychedelic-style care.
Tiffany designed rituals like four curated tea blends and double-blind testing to make the return-from-infusion moment grounding and intentional.

ADVICE

Instrument Everything To Unlock Coverage

Commit to measurement-based care from day one to build evidence for safety, efficacy, and insurance coverage.
Nico tracked 30,000 infusions to quantify rare complications and effectiveness to support payer conversations.

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Purpose can start as a conversation and grow into a clinic that saves lives. We sit down with Dr. Nico Grundmann and Tiffany Franke of Ember Health to explore how a marriage built on service turned into a patient‑centered model for IV ketamine that blends rigorous science, design thinking, and deep human care.

Nico breaks down the medical backbone: why ketamine’s decades of anesthetic safety matter, how weight‑based dosing and in‑room monitoring reduce risk, and what 30,000+ infusions taught the team about outcomes, side effects, and durability. Tiffany opens the black box of “set and setting,” showing how language, space, and therapeutic communication shape results—right down to crafting tea rituals and training clinicians to guide altered states with steadiness. Together, they explain why Ember won’t start without a third‑party diagnosis and a live handoff from a therapist or psychiatrist, and how therapy during the neuroplastic window turns rapid relief into lasting change.

We go inside powerful stories: a retiree who finally feels joy after decades of depression; a mother whose therapist said she couldn’t wait weeks for SSRIs and needed help now; adolescents stuck outside school and hope who regain traction with carefully coordinated care. We also tackle access head‑on. Out‑of‑pocket barriers are real, so Ember has been building the data case for coverage—partnering with perinatal and pediatric specialists, publishing real‑world results, and engaging insurers, the VA, Medicare, and employers to move this into mainstream mental health care.

If you’re curious about safety, set and setting, postpartum depression, adolescent treatment, or how insurance is changing, this conversation offers a clear view of what gold‑standard ketamine care looks like and why trust is the first medicine. If it resonates, share this episode with someone who needs options, subscribe for more purpose‑built insights, and leave a review to help others find the show.

John R. Boyd's Conceptual Spiral was originally titled No Way Out. In his own words:

“There is no way out unless we can eliminate the features just cited. Since we don’t know how to do this, we must continue the whirl of reorientation…”

A promotional message for Ember Health. Safe and effective IV ketamine care for individuals seeking relief from depression. Ember Health's evidence-based, partner-oriented, and patient-centered care model, boasting an 84% treatment success rate with 44% of patients reaching depression remission. It also mentions their extensive experience with over 40,000 infusions and treatment of more than 2,500 patients, including veterans, first responders, and individuals with anxiety and PTSD

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